Attitudes shifting on federal role in providing health insurance

For over a decade Gallup has been asking Americans whether the federal government should play a role in making sure people have health coverage. For years, there was a strong consensus that it did.

That consensus began to slip just before Obamacare was passed, and the slippage continues. The most recent poll shows a solid majority of Americans believe the federal government should not play a role in health coverage.

Not surprisingly, Republicans are overwhelmingly opposed on the question. But the critical voting block of independents has seen huge shifts.

"Fifty-five percent of independents currently say the government should not be involved with health care — an increase of 28 points since 2000," Gallup noted. "The percentage of Democrats who hold this view is now 30 percent, its highest level since Gallup first asked the question and an 11-point increase since 2000 — with the largest change in opinion occurring between 2006 and 2008."

Simultaneously, more Americans are citing health care costs and availability as a dominant policy concern, according to another Gallup poll. This one asks respondents to rank their concerns in order. Health care was in fourth place in September and October but shot up to second place in November, a period when the nation became heavily focused on insurance cancellations and other problems with the new health care law.

"This suggests that recent troubles with the federal health exchange website and other problems with the healthcare law's rollout, including accusations that President Barack Obama misled Americans about keeping their current coverage, may be fueling public concern," Gallup noted.

Approval ratings for the Affordable Care Act itself also fell over the same period, Gallup found, dropping from a close 47-44 disapproval a few weeks ago to a 55-40 split in mid-November.

The Gallup analysis noted the "timing of this drop in approval of the law suggests it may be linked to the controversy over the millions of Americans losing their current health insurance coverage," but also noted the respondents themselves rarely cited this concern, with just 11 percent focused on lost insurance.

"The leading complaint is a philosophical objection — government interference or forcing people to get healthcare — mentioned by 37 percent of those who disapprove. Twenty-one percent believe the law will increase costs and make health care less affordable," Gallup reported.